This document discusses common postoperative complications that can occur with silicon implants, specifically for the nose, cheeks, chin, and breasts. Some frequent complications include edema, redness, infections, abnormal pigmentation, transparent reflection of the implant, displacement of the implant, and rejection. Based on a study of 179 nose implants, 58 chin implants, 27 cheek implants, and 253 breast augmentations, the most common issues were edema, residual edema, redness, abnormal pigmentation, transparent reflection, infection, dissatisfaction leading to removal, and displacement of the implant. A unique complication of breast implants is capsule formation, requiring manual breaking for the first postoperative year. Rejection of implants is rare.

1. POST OPERATIVE COMPLICATIONS
WITHWITH SILICON IMPLANTS
Dr. Vijay SharmaDr. Vijay Sharma
PresidentPresident
Federation of Restorative and Cosmetic SurgeryFederation of Restorative and Cosmetic Surgery
Mumbai, INDIAMumbai, INDIA

2. ABSTRACT
Postoperative complications in the form of edema, redness,
infections are quite common in every surgery. But with the
increase role of various body implants, substitute in cosmetic
surgery, like nose implant, chin implant, cheek implant, breast
implant made of various inert substances like silicon, modified
silicon, silastic, poly urothene, zyderm, collagen, zyplast, bioplast
have enhanced some of the specific risks related to the body
implant surgery. Mainly these specific complications are in the
form of abnormal pigmentation, reflection of the implant
substances, dis-positioning of the implant, withdrawal of the
implants, acute, sub-acute and delayed reactions of the implants
does exist in a few number of patients.

3. INTRODUCTION
The role of body implants in surgical reconstruction is not new and does exist
almost since the birth of surgery. The dentures in the mouth, synthetic lenses in
the eyes, steel rods inside the bone, pacemakers inside the heart and other
body prosthesis are few of the brilliant examples of body substitutes.
Role of utilizing the various body prosthesis is the backbone of the cosmetic
surgery. Practically 60% of the cosmetic surgery is based on implantation. In
this scientific discussion some of the common complications related to the
implants are highlighted.
Specific features of implants:
Implantation of various body prosthesis helps to achieve the desired aesthetic
goals and satisfies the need of patients.

4. Some of the features of the implantations surgery are:
1. An instant improvement in the appearance.
2. The minimum destruction of the body tissue hence less
complication.
3. Maximum tissue respect
4. It has replaced the older technique of getting the bone grafts,
cartilage or the body tissue for reconstruction of defective nose, chin
and others.
5. Easy to handle and sterilize, readily available and has no limitations.
6. Implants can be easily withdrawn if not suitable or rejected or dis-
positioned or disliked or had a traumatic displacement.

5. Types of the prosthesis used:
1. Implants
a. Nose implants.
b. Cheek implants
c. Chin implants
d. Breast implants
2. Substitutes for the fat below the skin
a. Collagen
b. Zyderm
c. Zyplast
d,. Bioplast
e. Auto fat

6. Discussions
Study of implants surgery in the series of 179 nose implants, 58
chin implants, 27 pairs of cheek implants and 253 cases of breast
augmentation had the following complications in common
Sr. No. Cases Number
1 Nose implant 179
2 Chin implant 58
3 Pair of Cheek implants 27
4 Breast implants 253

7. Postoperative complications with silicon nose implants:
Sr. No. Complications Percentage
1 Edema 12%
2 Residual edema after six weeks 7.8%
3 Redness 12%
4 Abnormal pigmentation 3.2 %
5 Transparent reflection 43 %
6 Infection 6.2 %
7 Rejection 2.7 %
8 Dissatisfaction and withdrawal 4 %
9 Dispositioning 23 %

8. Postoperative complication with silicon cheek implants:
Sr. No. Complications Percentage
1 Edema 10.8%
2 Residual edema after six weeks 6.2%
3 Redness 3.3%
4 Abnormal pigmentation 4.6 %
5 Transparent reflection None
6 Infection 2.3 %
7 Rejection One left
8 Dissatisfaction and withdrawal 1.9 %
9 Dispositioning 32.4 %

9. Postoperative complications with silicon chin implants:
Sr. No. Complications Percentage
1 Edema 13.9%
2 Residual edema after six weeks 7.1%
3 Redness 9%
4 Abnormal pigmentation 2.4 %
5 Transparent reflection 39%
6 Infection None
7 Rejection None
8 Dissatisfaction and withdrawal 2 Cases
9 Dispositioning 9%

10. The most common complications as mentioned above with the
facial implants does not have the similar response with the breast
implants. The postoperative hardening of the breast due to
capsule formation which required manual breaking of capsule at a
regular interval of 1-3 months on an average for the first
postoperative year was quite common. No case of rejection of
breast implants is reported till date. One case of willful withdrawal
of the implant with the bigger size and one case of postoperative
wound opening after 72 hours and re-stitching has been
observed.

11. Conclusion
All the routine postoperative complications, which are common in
surgery in the form of edema, redness, discolourisation and infection
are quite under the control of modern medicines. The specific
complications with the body prosthesis namely abnormal pigmentation,
reflection of the implants substance, dispositioning of the implant,
withdrawal of the implant due to acute, sub-acute and delayed
rejections and traumatic displacement of the implants requires specific
attention observation and advanced measures to gain the Aesthetic
results.
Withdrawal of the implant due to rejection, disposition and traumatic
displacement are quite common but a limited number of cases of facial
implant, while postoperative hardening and manual capsule breaking is
the common complication and remedy with the breast prosthesis.
Role of Immuno Suppressive drugs for better acceptance of implants
yet not assessed and has open option for further studies

12. Thank youThank you
Dr. Vijay Sharma, M.D.
Mumbai, INDIA